Those with slow concussion recovery are more likely to repeatedly visit health-care professionals, miss school and, as a result, have parents who need to take time off of work. Finding ways to improve recovery has become a top priority.

Worse insomnia was also linked to worse post-concussion symptoms (for example headaches, balance problems and dizziness), worse anxiety and depression, as well as more self-reported problems with attention and memory.

Psychotherapy for insomnia

Unfortunately, there are very few evidence-based treatments to help with insomnia after concussion, so clinicians are often providing suggestions that may or may not actually work.

Our treatment trial found that a type of psychotherapy - called cognitive behavioural therapy for insomnia (or CBT-I) - provides remission of insomnia in 80 to 90 per cent of adolescents who were taking several months to recover from their brain injury. That is compared to remission rates of only nine per cent for those who did not have the treatment.

And the benefits of this therapy extended beyond just sleep improvement; there was also improvement in overall concussion recovery. That is, their level of post-concussion symptoms also dropped over time.

Sleep schedules are important

Commonly, after concussion, sleep routines get temporarily disrupted. Kids who go on to develop longer term sleep problems often do not return to a normal sleep routine. Instead of going to bed and getting up at a regular time, they go to bed and wake up later. They may also sleep less at night and start to compensate by taking more naps.

This disrupted schedule interferes with school and regular activities. As activities start to drop off, the motivation to get to bed and wake up at regular times also goes down.

One of the most important pieces of advice we give is to get back on a regular sleep schedule. In particular, this means setting and sticking to a regular wake-up time. Although getting up at the same time every day might feel hard at first, it gets kids back to normal activities (like getting to school on time) and it helps to ensure that when bedtime rolls around, they are actually sleepy.

Sleepiness (feeling like you could fall asleep) increases the longer that you've been awake. So if you get out of bed at 7 a.m. there is a good chance you'll want to fall asleep by 10 or 11 p.m. But if you get out of bed at noon, the need to sleep again won't actually occur until much later, say 2 a.m. or 3 a.m.

Setting a regular wake-up time helps to ensure that when kids crawl into bed at night they won't just lay there with minds racing.

Improve sleep, concussion may remit

The second most important piece of advice we give is to use your bed only for sleeping! This means that if a child is not sleeping, they shouldn't be lying in bed. If they need to rest but aren't sleepy, doing so on the couch is just fine.